Health Library

Bottle-Feeding

Health considerations when bottle-feeding

If you decide not to breastfeed, or are unable to breastfeed, commercial iron-fortified formulas can give your baby the nutrition he or she needs. Infant formulas have the right amounts of protein, calories, fat, vitamins, and minerals for growth. However, formula does not contain the immune factors that are in breast milk. The immune factors in breast milk help prevent infections.

Infants who take enough iron-fortified infant formula usually do not need vitamin and mineral supplements. However, the American Academy of Pediatrics recommends vitamin D supplementation for all babies drinking formula until they are drinking at least 32 ounces a day. Fluoride supplements are recommended for babies whose primary water supply is not fluoridated. Check with your baby's health care provider about fluoride supplements.

Types of infant formula

Cow's milk-based formula. Most infants should be able to tolerate a standard cow's milk formula. Cow's milk formulas are modeled after breast milk. These formulas have lactose as the carbohydrate (sugar) source. They are available in ready-to-feed cans, liquid concentrate, and powder. Regular cow's milk is not an appropriate source of nutrition for a baby.

Soy-based formulas. Soy-based infant formulas are used if an infant cannot tolerate lactose. Soy formulas do not contain lactose as the sugar source. In some cases, infants who are allergic to cow's milk formula can also be allergic to soy-based formulas. Consult your baby's health care provider before changing formulas. Vegetarian parents may prefer soy-based formulas.

Hydrolyzed formulas. Hydrolyzed formulas are easier to digest. They may be used in babies at risk for allergies. They are more expensive than regular formulas. Consult your baby's health care provider before using these formulas.

Low iron formulas. These formulas are not recommended.

Helpful hints for feeding your baby

Breast milk is best for your baby and is beneficial even if you only nurse for a short amount of time or part-time.

Wait until breastfeeding is well established (usually by 3 to 4 weeks of age) before introducing a bottle, unless instructed otherwise by your child's health care provider.

Working mothers can use a breast pump on break time and refrigerate or freeze the milk for later use as a bottle-feeding. Refrigerated breast milk should be used within 24 hours after pumping. Frozen breast milk is good for several months in the freezer. Fathers and other family members can be involved in feeding time if breast milk is offered from a bottle periodically.

Offer cow's milk-based formula with iron as first choice of formula if not breastfeeding.

Keep your baby on breast milk or baby formula until he or she is 1 year old. After this time, you may switch to whole milk. Children under 2 years should not drink skim or low-fat milk.

It is important to follow the formula preparation directions exactly as directed on the packaging. Using too much water can result in poor weight gain. It's also important to discuss your water supply with your child's health care provider. In some areas, water must be boiled first, or bottled water should be used.

Bottled should never be propped up.

Babies should never be put to sleep with a bottle. This can cause cavities to develop.

All babies, whether breast or bottle fed, should be offered a feeding whenever they show signs of hunger.